Food Pantry Capacity & Emergency Readiness Survey

Purpose

To understand food pantries' current capacity, constraints and opportunities for coordination during the on-going food assistance crisis. Responses will inform emergency funding decisions, resource coordination and shared purchasing strategies.

Basic Information

Organization Name

Primary Contact Name

Primary Contact Email

Primary Contact Phone

(XXX-XXX-XXXX)

Is your organization part of a larger network (e.g. church, agency, coalition)?

YesNo

Please list the name of the network.

Please explain

Service Volume & Scale

Number of households served per month. (please enter an estimated number)

Number of pounds or meals distributed per month. (please enter an estimated number)

	Significantly Increased	Increased	Remained the same	Decreased	Significantly Decreased
Please indicate how demand has changed in the past month (October)?

Approximate monthly food budget dollar amount (or enter 0 if all food is donated.)

Food Sources

Please indicate below the percentage of your supply that originates from each source.

Source % Notes

Purchased directly from grocery/retail stores

Purchased from food bank (e.g. Freestore Foodbank

Free from food banks or USDA commodities

Donations or community drives

Food rescue or prepared food recovery (e.g. Last Mile, La Soupe, grocery store partners)

Shared/cooperative purchasing with other organizations

Other (please specify in Notes)

Partnerships & Shared Solutions

Tell us about the networks and partners you work with and whether you are interested in shared purchasing or coordination of efforts.

Please Specify

Would your partnership be interested in participating in shared purchasing, delivery coordination or bulk ordering to reduce costs or stabilize supply?

YesNoMaybe-need more information

Provide any specific details or interest.

Are there existing resources, coordination efforts or solutions that we should know about?

Would you be interested in joining regular calls if the shutdown continues? If so, at what frequency?

DailyEvery other dayWeeklyNot interested

Capacity, Limitations & Crisis Response

Help us understand your pantry's current capacity, any operational challenges you are facing and how you are adjusting to meet increased community needs during the shutdown.

Please specify

Cold storage capacity: # of refrigerators/# of freezers

Are you planning any special distributions or changes in service in response to the shutdown/benefit delays?

YesNo

Please describe

What additional resources would most strengthen your response? (select up to 3)

Please describe

Data Accuracy & Populations Served

Please confirm that your pantry's information on 211 is current and note any populations or areas you prioritize in your service.

Please review your 211 resource record by visiting uwgc211.org and searching by your Agency Name. Is your pantry's information accurate (hours, location, eligibility)?

YesNoNot sure

Please send changes/updates to [email protected].

Additional Comments (optional)

If available, please provide an estimated percentage increase in demand.

Is there anything else we should know about your current needs, strengths or ways we could help coordinate resources?

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